Unstable ankle joints after internal fixation of type B malleolar fractures exist. Residual instability most often occurs after trimalleolar fractures with initial joint dislocation. Treatment with an additional positioning screw generally produced a satisfactory result.

Cytomegalovirus (CMV) continues to have a tremendous impact in solid organ transplantation despite remarkable advances in its diagnosis, prevention and treatment. It can affect allograft function and increase patient morbidity and mortality through a number of direct and indirect effects. Patients may develop asymptomatic viremia, CMV syndrome or tissue-invasive disease. Late-onset CMV disease continues to be a major problem in high-risk patients after completion of antiviral prophylaxis. Emerging data suggests that immunologic monitoring may be useful in predicting the risk of late onset CMV disease. There is now increasing interest in the development of an effective vaccine for prevention. Novel antiviral drugs with unique mechanisms of action and lesser toxicity are being developed. Viral load quantification is now undergoing standardization, and this will permit the generation of clinically relevant viral thresholds for the management of patients. This article provides a brief overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients.

Acute respiratory distress syndrome is characterised by rapid onset dyspnea, bilateral infiltrates on chest x-ray and respiratory failure. This may be due to conditions which directly affect the lung such as pneumonia, aspiration and near drowning. It may also be due to indirect lung injury, as in conditions like sepsis, pancreatitis, trauma and poisoning. The diagnostic criteria of ARDS, often described as the Berlin criteria is discussed in this presentation along with various management aspects of ARDS including ventilation strategies and use of antibiotics and diuretics. Finally prognostic features and alternative strategies are also discussed.

Knee replacement involves replacing a knee joint that has been damaged or worn away, usually by arthritis or injury. Find out more here: https://www.bupa.co.uk/health-....information/knee-cli

Full clinical and physical assessment of the knee and the knee joint

Laparotomy : opening the abdomen

This video shows an ovarian cyst and its removal using a laparoscopic technique.

Examination of the arms

Surgical removal of a Chalazion from the eye lid

Cerebellar functions of the lower limbs from the USMLE collection

This is a educational video for the prostate cancer patient and their family. Depending on the individual patient, a radical prostatectomy, might a procedure that your urologist could recommend as treatment.

Cricothyroidotomy NEJM

One Handed Surgical Knot

Fistulectomy surgery procedure video

Pilonidal disease with lateral extension - Follicle removal (Bascon's technique)

To present a new device for fixating the fibro-optic probe during phacoemulsification

Modern technique of thyroidectomy for tumors